Eltanolone as an Alternative to Propofol for Ambulatory Anesthesia

The intravenous (IV) steroid anesthetic, eltanolone, compares favorably to propofol with respect to its induction characteristics.This double-blind investigation was designed to compare the induction and recovery profile of eltanolone (versus propofol) when it was used for both induction and maintenance of ambulatory anesthesia. Eighty-three consenting ASA physical status I-III outpatients undergoing minor gynecologic or urologic procedures lasting 10-40 min were randomly assigned to one of three anesthetic treatment groups. All patients received midazolam, 2 mg IV, and fentanyl, 50 micro g IV, before induction of anesthesia. The control group (Group 1) was induced with propofol, 2.4 mg/kg IV (18-60 yr or ASA physical status I or II) or 1.6 mg/kg IV (61-80 yr and/or ASA physical status III), followed by intermittent bolus doses of 0.6 mg/kg IV in combination with N2 O 67% for maintenance of anesthesia. In Group 2, anesthesia was induced with eltanolone, 0.75 mg/kg IV, (18-60 yr and/or ASA physical status I or II) or 0.5 mg/kg IV (61-80 yr and/or ASA physical status III), and maintained with intermittent bolus injections of 0.2 mg/kg IV and N2 O 67%. Group 3 received eltanolone, 1.0 mg/kg IV (18-60 yr and/or ASA physical status I or II), or 0.75 mg/kg IV (61-80 yr and/or ASA physical status III), followed by intermittent bolus injections of 0.2 mg/kg IV and N2 O 67%. In addition to recording the induction and recovery times and side effects, psychomotor testing was performed before and at 30-min intervals after anesthesia. Induction times (57 +/- 23, 67 +/- 26, and 61 +/- 22 s, respectively) were similar in all three groups. Although eltanolone produced no pain on injection (versus 52% in the propofol group), 10% of the eltanolone-treated patients (versus none in the propofol group) developed transient cutaneous (rash-like) reactions. The total dose of study medication used during the anesthetic period was 9.2 +/- 3.7 mg [center dot] kg [center dot] h in the propofol group compared with 3.3 +/- 1.4 mg [center dot] kg [center dot] h and 3.3 +/- 1.9 mg [center dot] kg [center dot] h in Groups 2 and 3, respectively. Early recovery times were significantly shorter after propofol anesthesia. However, times to ambulation, micturition, and being judged "fit for discharge," as well as recovery of cognitive function, were similar in all three groups. Although ethanolone seems to be a safe and effective IV anesthetic, these data suggest that it is unlikely to replace